Distribution of CD4+ T-lymphocytes levels in patients with clinical symptoms of AIDS in three West African countries

Objectives: To study the CD4 T-lymphocyte distribution in patients with clinical signs suggestive of AIDS in West Africa. Design and methods: Selected patients had clinical AIDS, according to the WHO clinical definition of AIDS in Africa. Serum samples were tested for the presence of HIV antibodies with two different enzyme immunoassays (EIA), and whole blood was used to determine the CD4 lymphocyte levels of each patient, using the TRAx(R) CD4 Test Kit. Results: In patients with AIDS, the mean CD4 + cell level was 466/mu l; 34% of patients had less than 200/mu l and 62.1% less than 400/mu l. In patients with clinical AIDS but without HIV antibodies, the mean CD4 + cell level was 807/mu l; with 4% below 200/mu l and 14.7% below 400/mu l. The optimal CD4 + cell cut-off between the two groups of patients (with and without antibody to HIV) was 400/mu l. Conclusions: The mean CD4 cell levels of AIDS patients was more than twice the 200 CD4 + cells/mu l which, alone or associated with clinical criteria is used to differentiate HIV seropositive patients with and without AIDS. A cut-off of 400 T-lymphocyte equivalents per microlitre (TLE/mu l) will be more appropriate. Only 4% of the anti-HIV negative patients had < 200 CD4 TLE/mu l, and could be infected with unknown immunodeficiency viruses. (C) 1998 Elsevier Science B.V. All rights reserved.